Self-Adaptive Particle Swarm Optimization of CT Images for Diagnosis of Severe Traumatic Brain Injury

This paper aimed to explore the application values of computed tomography (CT) imaging in the treatment of patients with severe traumatic brain injury (STBI), to provide help in the treatment of STBI. In this study, 86 patients with STBI were selected as the research objects and examined by CT based on a self-adaptive particle swarm algorithm (APSO). Besides, patients were treated with hyperbaric oxygen, high-dose hormone shock, and naloxone hydrochloride. The results showed that there was a locally low-density brain contusion and laceration injury area, spot-like high-density hemorrhage, and subarachnoid hemorrhage in the images of CT examination. The ventricles of diffuse brain injury were compressed and reduced, and the white matter indicated that the ventricles and cisterns became smaller. Asymmetric hemorrhage and subarachnoid hemorrhage were scattered at the white matter junction. In short, subarachnoid hemorrhage, spot-like high-density hemorrhage at the injury site, and diminished ventricles were typical CT imaging manifestations of STBI. Naloxone hydrochloride method could effectively alleviate the matrix metalloproteinase-9 (MMP-9) (23.47 ± 3.45) and S100 calcium-binding protein B (S100B) (0.16 ± 0.06) of patients, which had reliable guiding significance for the later CT examination clinically.

Effect of naloxone hydrochloride on β-EP, CD4+, CD8+, IL2, MMP-9 and S100-B levels in peripheral blood after traumatic brain injury in rats

Purpose: To study the influence of naloxone hydrochloride on traumatic brain injury (TBI). Methods: Three groups of rats were used: normal control, TBI, and TBI + naloxone hydrochloride groups (12 rats/group). In the control group, only the osseous foramen was opened. Rats in TBI group were intraperitoneally injected with normal saline, while the naloxone group received naloxone hydrochloride injection at the same time. Changes in peripheral blood β-EP, CD4+, CD8+, IL-2, and S100-B levels; and brain tissue MMP-9 were assessed. Results: The levels of β-EP in the TBI- and naloxone-treated rats were higher than control values, while levels of CD4+ in TBI and naloxone groups were significantly lower than those of control group (p < 0.01). At every time point, CD8+ level in naloxone group was significantly lower than that in TBI group (p < 0.01). Compared with control group, the levels of IL-2 in the TBI and naloxone groups were significantly lower. Higher levels of S100-B were seen in TBI- and naloxone-treated rats, relative to control value. In the naloxone group, MMP-9 expression was downregulated, when compared to the expression TBI rats (p < 0.05). Conclusion: Naloxone hydrochloride reduces β-EP, alleviates inflammation, protects nerve cells and reduces brain injury in TBI rats. There is, thus, a potential to develop naloxone for the management of brain injury

The Role of the Social Network in Fatal Opioid Overdose Prevention: The Former Opioid User’s Perspective

Naloxone hydrochloride (naloxone) is an effective fatal opioid overdose prevention strategy. The study findings describe former opioid users’ phenomenological perspectives regarding their social network, settings of use, and the benefits and barriers to naloxone. Participants ( N = 25) with at least 6 months of recovery time ( M = 30, SD = 14.40) were interviewed individually for an average of 21 ( SD = 5.13) min. The sample was predominately male, Caucasian, and non-Hispanic with an average age of 37 ( SD = 7.22) years. Interview transcripts were analyzed using systematic thematic analysis. During their period of opioid use, most participants differentiated the members of their social network as other people who use opioids (PWUO) and nonusers. The participants described several opportunities for members of their social network to use naloxone. They discussed barriers to naloxone use specific to PWUO within their social network such as apathy toward overdose. Future interventions should be tailored to address naloxone use barriers specific to PWUO and nonusers.

Community Pharmacists’ Motivation and Barriers to Providing and Billing Patient Care Services

Recently, California (CA) pharmacists’ scope of practice has expanded to include independently prescribing self-administered hormonal contraceptives, nicotine replacement therapy medications, travel health medications, routine vaccinations, naloxone hydrochloride, and HIV preexposure and postexposure prophylaxis. However, previous reports indicate that practicing within this expanded scope has remained limited. Therefore, a 26-item, web-based survey was emailed to CA community pharmacists to assess pharmacists’ knowledge, intent, and barriers to prescribing and billing for these patient care services. A total of 216 chain, supermarket-based, independent, mass merchant, and health-system outpatient pharmacists were included. The primary services provided and medications prescribed are for vaccinations and naloxone. Most pharmacists agree that engagement in and implementation of new strategies to enhance patients’ access to care is important. Common barriers include patient unawareness of pharmacist-provided services, lack of payment for services, and difficulty incorporating services within pharmacy workflow. Pharmacists are confident in their ability to provide patient care services but are less knowledgeable and confident about billing for them. Enhancing promotion of pharmacist-provided services to patients, developing strategies to efficiently incorporate them into the workflow, and payment models can help overcome barriers to providing these services.